What is a Wound VAC?
A wound VAC (vacuum assisted closure) is a device which allows people to conduct negative pressure wound therapy (NPWT). The device consists of a dressing which is fitted with a tube and attached to the wound VAC. Negative pressure wound therapy is most commonly used with chronic wounds which are not responding to other forms of treatment, and sometimes with surgical wounds which have reopened. It usually requires the supervision of a nurse, although people do not need to be hospitalized to use a wound VAC.
The exact processes behind the functioning of a wound VAC on a biological level are not well understood. Numerous studies, however, have shown that using a wound VAC can decrease the amount of time required to heal and reduce the risk of infections and other complications.
To use the device, the wound is carefully cleaned, and a piece of sterile sponge is cut to fit inside the wound. Then, the sponge is sealed in place, usually with clear film, and a small slit is cut to allow a tube to project into the sponge. The tube is sealed in place and connected to a wound VAC, and the device is turned on, with the pressure being chosen by the wound care specialist who is in charge of the case. Periodically, the device is turned off for a dressing change in which the wound is also inspected.
For drainage, a wound VAC can be highly beneficial. The amount of time between dressing changes can be extended because the vac pulls out fluids which seep into the wound. This also keeps the environment unfriendly for bacteria. Using a wound VAC appears to increase perfusion, keeping circulation high and ensuring that blood reaches all areas of the wound. It also reduces edema or swelling, and appears to promote rapid tissue granulation, an important stage in the healing process.
Even with a wound VAC, a wound can take weeks or months to heal. The devices are usually designed to be portable so that patients can carry or wear them, allowing patients to go about their daily business while undergoing negative pressure wound therapy. Some patients are also taught to handle their own bandage changes, while others may go to a nurse or schedule regular visits from a home nurse for wound care. It is important to follow directions with this type of wound therapy to make sure that it is conducted properly.
If your doctor ever suggests a wound vac, tell them absolutely not! Unless you don't mind feeling like you're in prison or enjoy torture.
I have had my wound vac since the beginning of April due to necrotizing fasciitis. I had four surgeries within 12 days and ended up with a pretty impressive hole in my lower abdomen from my hip to my belly-button. It looked like a shark bite! I was sent home with the wound vac, and a home health agency comes to change the dressing.
I'm not going to lie: the first few dressing changes were bad. The foam used to pack the incision would literally have to be ripped out. No amount of saline or skin prep helped. Finally, one of the nurses tried using Restore, which is a mesh dressing used around the edges of the wound. Miracle! No more skin ripping! It helped so much. There are several brand names other than Restore. If anyone wants to research, look up 'contact layer dressing'.
Other than that, the wound vac isn't bad. I have nicknamed it Dracula. Sometimes I will forget to grab Dracula and walk away, but he pulls me right back. I guess he is attached to me. Ha!
Sorry, enough with the bad jokes. Just wanted to say to those of you recovering from a surgery or injury, I hope you continue to heal and feel better soon.
I recently had a bilateral mastectomy and had a hematoma at the incision site that turned necrotic after my staples came out, and required debreding a few times. The surgeon then requested a wound vac be used.
The visiting nurses come to my home to change it three times a week. The initial fitting of the packing was pretty uncomfortable, but they advised me to take pain meds before they came. I did have a problem with the packing being too dry and it wasn’t fun, so they have me take a modified shower to drench it for about ten minutes before they come and that made a huge difference.
As far as the pain factor, other than the initial dressing, it is actually better than the wet to dry dressing changes. The wound is now closing without further necrosis, and it is more comfortable with movement.
The biggest benefit besides the wound healing well, is you don’t get the odor that you have with the wet to dry dressing and no leakage to freak you out in the middle of the night. The unit’s carrying case can pretty well disguise the machine and tubing in my case.
I would advise you to not be afraid and try to relax when the dressings are done and it goes a lot easier. The benefits are well worth the discomfort. I do get some discomfort from the pressure on the wound, but it is not disabling more and annoyance discomfort. Hope this helps, because I was really afraid not knowing what to expect, but it’s not so bad.
I recently had a wound vac due to a staph infection that required a debridement on my ankle, from a shaving incident(probably didn't help I was on steroids at the time for migraines). The debridement left me with a hole nearly the size of a golf ball. The wound vac is honestly the biggest pain in the butt you will deal with. The tube wrapped around my leg while I slept, the vac alarm would go off in the middle of the night for one reason or another, and the frustration of carrying the bag around is insane.
All that being said, the would vac isn't tremendously painful as much as it is a pain to have. The most pain I had was on my first week of therapy when the hole was the biggest. The best thing that helps with the pain is elevation and resting the area. I don't really understand why I needed the vac (hey, I'm one of those old school people when it comes to going to doctors and ringing up bills when I don't feel they are necessary) but it is now 30 days since my debridement and my wound is closed and I received my artificial skin graft today. The doctor said I should be home free in about two weeks. I don't know if this helps, but it's just my story.
I will be having perianal Paget's surgery in a coupe of weeks and have been told they will use a wound vac. I don't understand how it will all stay in place after peeing. Anybody have suggestions?
I've had my wound vac since early April and this has been an ordeal. The doctor told me to premedicate before I got there, but with the medicine, it still hurts a lot. The smell of the tape and blood is disgusting and I'm ready for this to be over with.
These things are very painful in the beginning, but with time and more changes, it starts to hurt less. Be prepared though, when they take it off, if you still have an open wound, the pain in tremendous.
I have had one for a month and a half now after emergency abdominal surgery. I've got a serious staph infection so we're trying to go without for a while, but it's terrible and more painful to go without than with.
On the intermittent setting, it didn't hurt that much, but on the constant setting, the pain is pretty bad.
My best friend is paralyzed, diabetic and has been bed-ridden with pressure sores for years. He recently was placed on the wound-vac and his sores are almost healed. I had never heard of this therapy, so have been researching it a bit.
To the person who asked if it hurts: he did not indicate any pain - only joy that the therapy is finally freeing him!
I had a partial hysterectomy and my incision opened almost completely and is infected. I am going on the wound vac tomorrow. Does anyone know if it hurts, so I can prepare myself. Pain and I don't work well.
I had surgery two weeks ago and I have four open wounds in my groin. Three of them are healing well. They're taking their time, but the nurse said that they will heal lovely. I also have one right on my knicker line. I'm having my district nurse come out every day to pack them all but they are concerned that the one on my knicker line is not healing very well and were thinking about giving me the wound vac because it is very wet and because it's in a awkward place the dressing isn't sticking well and because I'm a girl, they can't dress it in a different way because it will stop me peeing. Do you recommend that I have the wound VAC? Please help me because I'm driving myself round the bend in worry.
How do you get help to pay for a wound vac? My sister has an open wound and the doctor ordered one for her, but her medicaid will not pay for it.
I had a wound vac when a spider bite left a lemon sized hole in my lower leg. It really sped up the healing. Dressing changes were less frequent and less painful, I loved having it!
Having the hose and box to carry around (and sometimes get tangled) was inconvenient but much better than the old fashioned way. My results varied depending on the nurse who changed the dressing. Each had their own technique, some better than others. But even the least effective technique was wonderful.
I am an RN who has used NPWT, commonly called wound vacs. I have used the kind that require foam dressing and the kind that use gauze dressing.
I prefer the gauze. They are less expensive, less painful and a smaller unit for the patient to handle. For pain, I recommend premedication and dampening dressings before removal. It disrupts the healing process if you pull healthy cells out with a dry dressing.
@anon138417: I have taken care of patients who have had wound vacs and I was taught by the company supplying the vacs to moisten the old dressing with saline before removing. It keeps the dressing from pulling on the wound bed. Also try using skin prep on the area around the wound and the putty around the tubing under the clear film. Hope this helps.
After surgery for necrotizing fasciitis in my thigh and groin, I was put on wound vac therapy. The positives are that the surgical wound is healing very well, and faster than without the vac.
The negatives are that it is painful to change -- lidocaine is the key and have the sponge soaked prior to change. Also, depending on the area, it needs constant taping and reinforcement of the tape.
Overall, it is working great. I'm on my fourth week and the wound has healed 75 percent.
I have had a wound vac for about a month after having gangrene debridement surgery. My doctor says I am healing fine. No pain anymore. My dressing is changed three times a week.
My daughter was involved in an automobile accident and had to have a metal plate put into her leg. The incision became infected and they had to go back into it and re-open it and clean it out. It became infected again and this time they re-opened it and put in a wound vac.
Her wound was 24 centimeters long, 8 centimeters wide, and 4 centimeters deep. She has had her wound vac for a month and they are removing it this week, even though they expected it to be in for 6-8 months.
It has been great, but she was blessed with a wonderful home health nurse. The first change was quite painful but then she got a different nurse and does not dread it at all now.
To CheeryOne: Yes, maggots are still used in some parts of the world - particularly third world. It's still an effective debridement technique; the maggots eat only dead or septic tissue and do not penetrate healthy or living tissue planes. Still somewhat difficult to accept in USA. Besides, when the maggots turn to flies and then fly away, it can become a little messy. --from a surgeon
I had a wound vac in the hospital following a c-section. It seemed to work well as my incision healed up beautifully. My only complaint is that it was difficult to try to get out of bed and move it around while trying to carry a newborn, but if I have another surgery, I will request it.
Have the specialist put lidocaine down the tube. It goes into your wound, and there's little if any pain for the dressing change! My first change was torture, and I've had them use lidocaine for the last couple weeks. Wow, what a miracle fix!
I have had my wound vac following spinal surgery and staph infection for almost two weeks. It has been a very painful ordeal. The area around the wound vac stings constantly and when it is changed, the pain of the nurse ripping the dry dressing out of the tender raw wound makes me almost pass out. My nurse calls first so that I can premedicate with pain pills, but this has been the most miserable and painful event in my life.
I have had a wound vac. for about three weeks. My leg is healing great. The only problem I have is where my wound is located it makes it hard for me to get around. My wound is now about 25 percent healed.
Thank you so much for writing this article. I will be receiving my wound vac on Monday and will be fitted with it on wednesday. it truly explained to me how it works and what it actually does as I had no clue at this writing! So thank you!
I was kind of scared to know what it did because I was clueless. I now am ready for this to heal my wounds as for whatever reasons, whether my medicines or having just a bad body, it's so good to know there are doctors who use such great machines to help us all get better! Thank you again!
Do they still use maggots in America? I saw this documentary on a health channel about a woman’s wound that wouldn’t heal. The doctor put maggots into the one inch deep gash and sealed it for about a week.
The patient came back and the wound was completely rid of all dead tissue; he removed all of the larvae and the wound began to heal correctly. I don’t know if I could stand the feeling of literally having bugs crawling under your skin!
Following an error by a surgeon, my friends’ dad had to use one of these too. The surgeon nicked his pancreas and it leaked fluid into his cavity, causing damage throughout his entire body. It was weird to see a wound kept open to drain fluid. I’m used to my body just absorbing fluids or naturally flushing things out.
This is a very helpful article. My father was just recently equipped with a wound vac, and this really helps to understand what is going on inside his wound. Thanks for a very educational, yet simple explanation!
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